The American Journal of Medicine
Volume 119, Issue 7, Supplement 1 , Pages S12-S16 , July 2006

Brain Volume Regulation in Response to Hypo-osmolality and Its Correction

  • Richard H. Sterns, MD

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to Richard H. Sterns, MD, Rochester General Hospital, 1425 Portland Avenue, Rochester, New York 14621.
  • ,
  • Stephen M. Silver, MD

References 

  1. Arieff AI , Llach F , Massry SG . Neurological manifestations and morbidity of hyponatremia (correlation with brain water and electrolytes) . Medicine . 1976;55:121–129
  2. Tomlinson BE , Pierides AM , Bradley WG . Central pontine myelinolysis (two cases with associated electrolyte disturbance) . Q J Med . 1976;45:373–386
  3. Adams RD , Victor M , Mancall EL . Central pontine myelinolysis (a hitherto undescribed disease occurring in alcoholic and malnourished patients) . AMA Arch Neurol Psychiatry . 1959;81:154–172
  4. Martin RJ . Central pontine and extrapontine myelinolysis (the osmotic demyelination syndromes) . J Neurol Neurosurg Psychiatry . 2004;75(suppl 3):iii22–iii28
  5. Sterns RH , Riggs JE , Schochet SS . Osmotic demyelination syndrome following correction of hyponatremia . N Engl J Med . 1986;314:1535–1542
  6. Sterns RH , Cappuccio JD , Silver SM , Cohen EP . Neurologic sequelae after treatment of severe hyponatremia (a multicenter perspective) . J Am Soc Nephrol . 1994;4:1522–1530
  7. Sterns RH . Severe symptomatic hyponatremia: treatment and outcome: a study of 64 cases . Ann Intern Med . 1987;107:656–664
  8. Sterns RH , Thomas DJ , Herndon RM . Brain dehydration and neurologic deterioration after rapid correction of hyponatremia . Kidney Int . 1989;35:69–75
  9. Sterns RH , Baer J , Ebersol S , Thomas D , Lohr JW , Kamm DE . Organic osmolytes in acute hyponatremia . Am J Physiol . 1993;264(pt 2):F833–F836
  10. Lien YH , Shapiro JI , Chan L . Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia (implications for the pathogenesis of central pontine myelinolysis) . J Clin Invest . 1991;88:303–309
  11. Verbalis JG , Gullans SR . Hyponatremia causes large sustained reductions in brain content of multiple organic osmolytes in rats . Brain Res . 1991;567:274–282
  12. Videen JS , Michaelis T , Pinto P , Ross BD . Human cerebral osmolytes during chronic hyponatremia (a proton magnetic resonance spectroscopy study) . J Clin Invest . 1995;95:788–793
  13. Restuccia T , Gomez-Anson B , Guevara M , et al.   Effects of dilutional hyponatremia on brain organic osmolytes and water content in patients with cirrhosis . Hepatology . 2004;39:1613–1622
  14. Verbalis JG , Drutarosky MD . Adaptation to chronic hypoosmolality in rats . Kidney Int . 1988;34:351–360
  15. Verbalis JG , Martinez AJ . Neurological and neuropathological sequelae of correction of chronic hyponatremia . Kidney Int . 1991;39:1274–1282
  16. Laureno R . Central pontine myelinolysis following rapid correction of hyponatremia . Ann Neurol . 1983;13:232–242
  17. Kleinschmidt-DeMasters BK , Norenberg MD . Neuropathologic observations in electrolyte-induced myelinolysis in the rat . J Neuropathol Exp Neurol . 1982;41:67–80
  18. Hew-Butler T , Almond C , Ayus JC , et al.  Exercise-Associated Hyponatremia (EAH) Consensus Panel   Consensus statement of the 1st International Exercise-Associated Hyponatremia Consensus Development Conference, Cape Town, South Africa 2005 . Clin J Sport Med . 2005;15:208–213
  19. Verbalis JG , Gullans SR . Rapid correction of hyponatremia produces differential effects on brain osmolyte and electrolyte reaccumulation in rats . Brain Res . 1993;606:19–27
  20. Soupart A , Silver S , Schroeder B , et al.   Rapid (24-hour) reaccumulation of brain organic osmolytes (particularly myo-inositol) in azotemic rats after correction of chronic hyponatremia . J Am Soc Nephrol . 2002;13:1433–1441
  21. Lien YH . Role of organic osmolytes in myelinolysis (a topographic study in rats after rapid correction of hyponatremia) . J Clin Invest . 1995;95:1579–1586
  22. Haussinger D , Laubenberger J , vom Dahl S , et al.   Proton magnetic resonance spectroscopy studies on human brain myo-inositol in hypo-osmolarity and hepatic encephalopathy . Gastroenterology . 1994;107:1475–1480
  23. Baker EA , Tian Y , Adler S , Verbalis JG . Blood-brain barrier disruption and complement activation in the brain following rapid correction of chronic hyponatremia . Exp Neurol . 2000;165:221–230
  24. Adler S , Verbalis JG , Williams D . Effect of rapid correction of hyponatremia on the blood-brain barrier of rats . Brain Res . 1995;679:135–143
  25. DeLuca GC , Nagy Z , Esiri MM , Davey P . Evidence for a role for apoptosis in central pontine myelinolysis . Acta Neuropathol . 2002;103:590–598
  26. Decaux G , Brimioulle S , Genette F , Mockel J . Treatment of the syndrome of inappropriate secretion of antidiuretic hormone by urea . Am J Med . 1980;69:99–106
  27. Van Reeth O , Decaux G . Rapid correction of hyponatraemia with urea may protect against brain damage in rats . Clin Sci . 1989;77:351–355
  28. Soupart A , Penninckx R , Stenuit A , Decaux G . Azotemia (48 h) decreases the risk of brain damage in rats after correction of chronic hyponatremia . Brain Res . 2000;852:167–172
  29. Silver SM , Schroeder BM , Sterns RH . Brain uptake of myoinositol after exogenous administration . J Am Soc Nephrol . 2002;13:1255–1260
  30. Silver SM , Schroeder BM , Sterns RH , Rojiani AM . Myoinositol administration improves survival and reduces myelinolysis after rapid correction of chronic hyponatremia in rats . J Neuropathol Exp Neurol . 2006;65:37–44

PII: S0002-9343(06)00489-X

doi: 10.1016/j.amjmed.2006.05.003

The American Journal of Medicine
Volume 119, Issue 7, Supplement 1 , Pages S12-S16 , July 2006